Background The anterior inferior iliac spine (AIIS) contributes to hip dysfunction in patients with symptomatic impingement and resection of a prominent AIIS can reportedly improve function. However, the variability of the AIIS morphology and whether that variability correlates with risk of associated symptomatic impingement are unclear. Questions/purposes We characterized AIIS morphology in patients with hip impingement and tested the association between specific AIIS variants and hip range of motion.Methods We evaluated three-dimensional CT reconstructions of 53 hips (53 patients) with impingement and defined three morphological AIIS variants: Type I when there was a smooth ilium wall between the AIIS and the acetabular rim, Type II when the AIIS extended to the level of the rim, and Type III when the AIIS extended distally to the acetabular rim. A separate cohort of 78 hips (78 patients) with impingement was used to compare hip range of motion among the three AIIS types.

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Focal cam and/or rim osteoplasty can reliably improve hip kinematics and range of motion in patients with symptomatic FAI, particularly the limitation of internal rotation in a flexed position. Computed tomography-based computer modeling can localize regions of anticipated mechanical impingement in symptomatic patients. A complete osteoplasty in these defined regions, through an arthroscopic or open approach, predictably improves range of motion and may help to eliminate the recurrent mechanical collision and secondary chondral injury associated with FAI.

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